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1. Primary Health Care and Primary Health Care and
Service Integration: Service Integration:
Improving Healthcare in Mount Improving Healthcare in Mount
WaddingtonWaddington
Victoria PowerVictoria Power
Director, Primary Health Care, Director, Primary Health Care,
Chronic Disease Management & Chronic Disease Management &
Rural Health ServicesRural Health Services
September 22, 2010September 22, 2010

2. What You Requested to HearWhat You Requested to Hear
What is primary health care and how does it differ from
traditional health care?
 
There are 5 facilities in Mt. Waddington.
  What
changes will we see at the sites related to primary
health care?
Please review the Mt. Waddington redesign structure
to explain how the principles of primary health care are
rolling out at each facility.
Please explain how this affects the way doctors and
staff do their jobs and provide care.

3. Mount Waddington Mount Waddington
Redesign for IntegrationRedesign for Integration
Changing the way we
plan and provide
services:
“Identify the best
supports to ensure
success and
sustainability of this
work”

4. The Focus is on Two Goals:The Focus is on Two Goals:
1. Improve the health of Mount
Waddington people and communities
2. Demonstrate an integrated
management solution for
rural and remote
communities

5. Mount Waddington Vision: A Primary Mount Waddington Vision: A Primary
Health Care ApproachHealth Care Approach
“Comprehensive, seamless and locally
accessible primary health care services delivered
by a network of provider teams, integrated into a
regional health care system that supports our
population to stay healthy, get better, manage
illness and disease, and cope with the end of
life.”
Mt. Waddington Health Service Plan 2007

6. What is Primary Health Care?What is Primary Health Care?
VIHA Working Definition
Primary health care is the range of services and
supports that individuals and communities receive
on an ongoing basis in order to stay healthy, get
better, manage illness and disease and cope with
end of life.
VIHA Primary Health Care Strategy June 2006

7. An approach to health services An approach to health services
delivery across the systemdelivery across the system
Key Attributes of Approach:
a.First point of contact to access care
b.Comprehensiveness of care
c.Coordination of care
d.Continuity of care

8. Traditional Care vs Primary Health CareTraditional Care vs Primary Health Care
Episodic / urgent in nature
Services typically delivered
in silos
Treating illness one person
(and one illness) at a time
Referral to other
providers…your story over
& over
Sometimes long waits
Coordinated, proactive
service
Care delivered through
integrated approach
Patients, families & care
givers as partners
Focus on self-management
Population health approach

9. New Service Delivery FrameworkNew Service Delivery Framework
Service Delivery Framework – Regionally Integrated Services














Senior Manager
MW Health Service
Chief of Staff
MW Health Services
Manager, Acute /
Primary / Public
Health
Manager Mental
Health/ Home &
Community Care /
Residential Care
Aboriginal
Health

Mount Waddington Service Integration Team
Mount Waddington Health
Network
Local Medical Advisory
Committee
North Island Division of
Family Practice
Collaborative Services
Committee

10. ‘Namgis Health
Services (FN)
Mt Waddington’s
Regional Services
Port Hardy Cluster
of Integrated
Services
Port McNeill
Cluster of
Integrated
Services
Port Alice Primary
Health Centre
Sointula Nursing Centre
Holberg
Fort Rupert
Gwa’sala-nakwaxda’xw
Quatsino
Kingcome (outreach)
Woss
Integrating VIHA Services in Mount Waddington…Integrating VIHA Services in Mount Waddington…
Guilford (outreach)
Hopetown
Cormorant Island
Service Cluster

11. An approach to health services An approach to health services
delivery across the systemdelivery across the system
Key Attributes of Approach:
a.First point of contact to access care
b.Comprehensiveness of care
c.Coordination of care
d.Continuity of care

12. First Point of ContactFirst Point of Contact
Same Day Appointments
Group Visits
Nurse Practitioners
Fly-in teams
Telehealth
Expanding Scope of Practice

13. Comprehensiveness of CareComprehensiveness of Care
Integrated Care Teams & Community
Partnerships
Chronic Disease Management supports
Mental Health Supports
Divisions of Family Practice &
Collaborative Services Committees
VIHA Rural Health Framework

14. Divisions of Family PracticeDivisions of Family Practice
Groups of physicians
organized at a
community level:
Working together to
address common health
care goals for their
communities
Influencing population
health

15. What Divisions Offer …What Divisions Offer …
Networking support for communities of
physicians.
Avenue for health system decision-makers to
effectively engage community GPs.
Opportunities for enhanced clinical services,
developed and supported in collaboration with
partners.

16. Coordination of CareCoordination of Care
Community Health Integration Initiative
A single patient care plan that can be
accessed across the health care system
and created in partnerships with patients
Shared care between patient, NP-GP and
specialists
Improved communication during care
transitions

17. Patient as PartnersPatient as Partners
A collaborative relationship between
patients (and their families and
caregivers) and health care professionals
so that patients can achieve better health
Patients have a better experience at a
reasonable cost
Supporting patients to have greater
confidence in managing their own care

18. Patient as Partners Goals:Patient as Partners Goals:
Voice
Choice
Representation
www.patientvoices.ca

19. Continuity of CareContinuity of Care
 Attachment of every willing British
Columbian to a family practitioner will
reduce the number of emergency room
visits and hospital admissions.
Maternity, Residential, End-of-Life,
Inpatient care incentives in place
Hollander, M.J., Kaldec, H., Hamdi, R., & Tessaro, T. (2009) Increasing value for money in the Canadian healthcare
system: New findings on the contribution of primary care. Healthcare Quarterly, 12(4), 30-42.

20. Benefits of AttachmentBenefits of Attachment
For patients
More appropriate
preventative care.
Better access to long-
term and coordinated
care.
For physicians
Strong support through
health care partners
Incorporate inter-
professional care teams.
Understanding of patient
population/needs.
2020 of ? of ?

21. Attachment Benefits to Attachment Benefits to
SystemSystem
Health system
annual cost for
person living with
diabetes
Unattached:
$10,175
Attached
$4,027
Health system
annual cost for
person living with
heart failure
Unattached:
$16,710
Attached
$7,379
2121 of of

22. Rural Health Services FrameworkRural Health Services Framework
& Strategy & Strategy
Vision: Healthy people, healthy
rural communities, integrated
service

23. Next Steps…looking toward the Next Steps…looking toward the
futurefuture

24. Questions/
Discussion
http://www.viha.ca/phc_cdm/